Question 1

Is RCM Employee HIPAA compliant?

Accepted Answer

Yes. RCM Employee is a Business Associate under HIPAA. PHI is processed entirely under a signed BAA chain — Covered Entity → RCM Employee → HIPAA-compliant cloud provider → AI model provider. PHI is encrypted at rest with KMS-managed customer master keys, encrypted in transit with TLS 1.2+, isolated per tenant via Row-Level Security, and audited in an append-only 7-year audit log.

Question 2

What payers does RCM Employee support?

Accepted Answer

All U.S. payers via API-first integration. Direct: CMS HETS (Medicare eligibility), UHC FHIR R4, Aetna FHIR R4. Clearinghouse: Stedi (270/271 eligibility, 276/277 claim status, 837 claim submission, 835 remittance, 278 prior auth) and Availity as fallback. Plus state Medicaid via dedicated MCP integrations and the long-tail of commercial payers via the clearinghouses.

Question 3

Does RCM Employee use browser automation to access payer portals?

Accepted Answer

No. All payer and EHR data access is API-only — no browser automation, no portal scraping, no shared credentials. APIs are auditable, encrypted in transit, deterministic, and eliminate PHI exposure via screenshots, cookies, or browser state.

Question 4

What does RCM Employee cost?

Accepted Answer

Standard tier: $3,500/month for all 12 Digital FTEs with business-hours coverage (Mon–Fri 8 AM–5 PM). Professional tier: $5,500/month for all 12 Digital FTEs with 24/7 coverage. Pay-as-you-go: credit-based, billed by task complexity, $250/month minimum. Custom: usage- and credit-based pricing for enterprise, seasonal, and workflow-specific plans.

Question 5

How many Digital FTEs are included in each subscription?

Accepted Answer

All twelve. There is no 'upgrade for more agents' path. Every subscription tier includes the full team: RCM-INTAKE (registration & scheduling), RCM-ELIG (eligibility), RCM-CODING (medical coding), RCM-CLAIMS (claims submission), RCM-AUTH (prior auth), RCM-AR (A/R follow-up), RCM-PAY (payment posting), RCM-APPEAL (denials & appeals), RCM-DOCS (documents & scribe), RCM-OPS (provider operations), RCM-COMPLY (compliance & quality), and RCM-ANALYTICS (analytics & reporting). Upgrading from Standard to Professional adds 24/7 coverage, not additional agents.